BVA9511008
DOCKET NO. 93-14 819 ) DATE
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On appeal from the decision of the
Department of Veterans Affairs Regional Office in St.
Petersburg, Florida
THE ISSUE
Entitlement to service connection for degenerative joint
disease of the lumbosacral spine as secondary to serviced
connected synovitis with torn medial meniscus of the right
knee and chondromalacia of the left knee.
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
Ronald R. Bosch, Counsel
INTRODUCTION
The veteran served on active duty from January 1971 to March
1973.
The claims file contains a report of a rating decision dated
in August 1991 wherein the RO denied entitlement to service
connection for degenerative joint disease of the lumbosacral
spine on direct and secondary bases.
The current appeal arose from a December 1991 rating decision
of the Department of Veterans Affairs (VA) Regional Office
(RO) in St. Petersburg, Florida. The RO affirmed the August
1991 rating decision.
The case has been forwarded to the Board of Veterans' Appeals
(Board) for appellate review.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran contends that he developed degenerative joint
disease of the lumbosacral spine as the result of his
service-connected bilateral knee disabilities. He directs
the Board's attention to the opinion of his private physician
in this regard.
DECISION OF THE BOARD
The Board, in accordance with the provisions of 38 U.S.C.A.
§ 7104 (West 1991), has reviewed and considered all of the
evidence and material of record in the veteran's claims file.
Based on its review of the relevant evidence in this matter,
and for the following reasons and bases, it is the decision
of the Board that the record supports a grant of entitlement
to service connection for degenerative joint disease of the
lumbosacral spine as secondary to the service-connected
bilateral knee disabilities.
FINDING OF FACT
Degenerative joint disease of the lumbosacral spine is
causally related to the veteran's service-connected bilateral
knee disabilities.
CONCLUSION OF LAW
Degenerative joint disease of the lumbosacral spine is
proximately due to or the result of service-connected
synovitis with torn medial meniscus of the right knee and
chondromalacia of the left knee. 38 U.S.C.A. § 5107 (West
1991); 38 C.F.R. § 3.310(a) (1994).
REASONS AND BASES FOR FINDING AND CONCLUSION
Initially, the Board finds that the veteran's claim is well
grounded within the meaning of 38 U.S.C.A. § 5107(a), in that
he has presented a claim which is plausible. The Board is
satisfied that all relevant facts have been properly
developed, and that no further assistance to the veteran is
required in order to comply with 38 U.S.C.A. § 5107(a).
The basic issue presented for appellate resolution is whether
the veteran's degenerative joint disease of the lumbosacral
spine is causally related to his service-connected synovitis
with torn medial meniscus of the right knee and
chondromalacia of the left knee. In this regard, the Board
observes that in July 1991, when the veteran was seen by VA
on an outpatient basis, he reported a history of low back
spasms of two years duration. The VA examiner noted that the
appellant's low back spasm may be related to his knee
problems.
On file is a private hospital report which shows the veteran
was admitted in September 1991 for evaluation of
symptomatology including a three and one half week history of
back pain.
A July 1992 VA outpatient treatment report noted that the
veteran had tested positive for the rheumatoid factor in a
laboratory study.
The veteran provided testimony at an RO hearing held in
September 1992. He testified as to his back and lower
extremity pain. He was employed as a mail handler and wore
braces on both knees.
On file are VA outpatient treatment reports dated in
September 1992 which show the veteran was treated for back
and knee pain.
In 1992 the veteran submitted an excerpt from a private
medical manuscript pertaining to trauma as a factor in the
initiation of osteoarthritis.
The claims file contains a letter dated in September 1992
from John R. Caruso, D.O., the claimant's private family
physician of nearly ten years. Dr. Caruso noted that during
his nearly ten year treatment of the veteran he had had the
opportunity to complete a comprehensive history and physical
and had treated him for his service related injuries. During
the past two years the veteran had been suffering from
multiple joint pain including the back. Dr. Caruso noted
that it was a well known fact that trauma is a major factor
in the initiation and progression of osteoarthritis. The
knee and ankle joints were especially susceptible to trauma
induced osteoarthritis. It was also generally accepted that
stress on normal functioning body parts may render such body
parts susceptible to development of degenerative arthritic
pathology in an attempt to overcome the limitations placed
upon the body by the arthritic part. At present, the veteran
had extensive degenerative problems which had developed since
his initial knee injury. In Dr. Caruso's professional
opinion and experience the veteran's degenerative problems
were attributable to the initial knee injury.
The Board interprets the correspondence from the veteran's
private physician as an endorsement that his degenerative
joint disease in the lumbosacral spine is not only causally
related to the veteran's originally incurred service injury,
but is also etiologically related to such injury by way of
aggravation. Allen v. Brown, U.S. Vet.App. 93-245 (Mar. 17
1995).
The record contains information as to the veteran having
tested positive as to the rheumatoid factor; however, the
record is devoid of detailed rheumatologic studies
as to confirmation of any rheumatoid disease process in any
joint(s). There is no evidence of record to counter the
opinion of the appellant's private physician. Accordingly
the Board is of the opinion that the record supports a grant
of entitlement to service connection for degenerative joint
disease of the lumbosacral spine as secondary to the
veteran's service-connected synovitis with torn medial
meniscus of the right knee and chondromalacia of the left
knee. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.310(a).
ORDER
Entitlement to service connection for degenerative joint
disease of the lumbosacral spine as secondary to service
connected synovitis with torn medial meniscus of the right
knee and chondromalacia of the left knee is granted.
ALBERT D. TUTERA
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___
(1994), permits a proceeding instituted before the Board to
be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting
less than the complete benefit, or benefits, sought on appeal
is appealable to the United States Court of Veterans Appeals
within 120 days from the date of mailing of notice of the
decision, provided that a Notice of Disagreement concerning
an issue which was before the Board was filed with the agency
of original jurisdiction on or after November 18, 1988.
Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402
(1988). The date which appears on the face of this decision
constitutes the date of mailing and the copy of this decision
which you have received is your notice of the action taken on
your appeal by the Board of Veterans' Appeals.